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Elevated osteoprotegerin is associated with abnormal ankle brachial indices in patients infected with HIV: a
James J Jang1, Aron I Schwarcz, Daniel A Amaez
1Zena and Michael A Wiener Cardiovascular Institute and Marie-Joseìe and Henry R Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine, New York, New York, USA. james.j.jang@kp.org
Insights
Peripheral arterial disease (PAD) affects 11% of young HIV-infected patients. Traditional risk factors and elevated osteoprotegerin levels are linked to PAD, suggesting early screening is crucial.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Immunology
Background:
- HIV infection is linked to accelerated atherosclerosis and increased cardiovascular disease risk.
- Elevated osteoprotegerin levels are associated with cardiovascular events and mortality.
- Peripheral arterial disease (PAD) is a significant manifestation of cardiovascular disease.
Purpose of the Study:
- To determine the prevalence of PAD in HIV-infected individuals.
- To identify associations between PAD and HIV-specific/traditional cardiovascular risk factors.
- To investigate the relationship between PAD and osteoprotegerin levels in this population.
Main Methods:
- A cross-sectional study involving 102 HIV-infected patients.
- Ankle-brachial indices (ABIs) were measured to assess PAD prevalence.
- Medical history and laboratory data were collected to identify risk factors.
Main Results:
- PAD prevalence was 11% in the HIV-infected cohort (mean age 48).
- Traditional risk factors (age, prior cardiovascular history, CRP) were associated with PAD.
- Elevated osteoprotegerin levels were observed in patients with high ABIs compared to those with normal ABIs.
Conclusions:
- A significant prevalence of PAD exists in young HIV-infected patients.
- PAD in this population is associated with traditional cardiovascular risk factors and elevated osteoprotegerin.
- Early screening and proactive management of PAD are recommended for HIV-infected individuals.
Background:
Patients infected with HIV have an increased risk for accelerated atherosclerosis. Elevated levels of osteoprotegerin, an inflammatory cytokine receptor, have been associated with a high incidence of cardiovascular disease (including peripheral arterial disease, or PAD), acute coronary syndrome, and cardiovascular mortality. The objective of this study was to determine whether PAD is prevalent in an HIV-infected population, and to identify an association with HIV-specific and traditional cardiovascular risk factors, as well as levels of osteoprotegerin.
Methods:
One hundred and two patients infected with HIV were recruited in a cross-sectional study. To identify the prevalence of PAD, ankle-brachial indices (ABIs) were measured. Four standard ABI categories were utilized: < or = 0.90 (definite PAD); 0.91-0.99 (borderline); 1.00-1.30 (normal); and >1.30 (high). Medical history and laboratory measurements were obtained to determine possible risk factors associated with PAD in HIV-infected patients.
Results:
The prevalence of PAD (ABI < or = 0.90) in a young HIV-infected population (mean age: 48 years) was 11%. Traditional cardiovascular risk factors, including advanced age and previous cardiovascular history, as well as elevated C-reactive protein levels, were associated with PAD. Compared with patients with normal ABIs, patients with high ABIs had significantly elevated levels of osteoprotegerin [1428.9 (713.1) pg/ml vs. 3088.6 (3565.9) pg/ml, respectively, p = 0.03].
Conclusions:
There is a high prevalence of PAD in young HIV-infected patients. A number of traditional cardiovascular risk factors and increased osteoprotegerin concentrations are associated with abnormal ABIs. Thus, early screening and aggressive medical management for PAD may be warranted in HIV-infected patients.